What Actually Works for Anxiety?

Understanding Anxiety

Let's just start off with two simple ideas that underlie what anxiety is. The first is that anxiety, as an emotion, is like a gas. If you give it a stadium-sized room, it will fill up all of the space available. It's why things that "feel small" can actually feel incredibly distressing and catastrophic. It's a very difficult emotion to contain.

Second, is that from a neurological perspective, anxiety often reflects the idea that "where attention goes, neurons flow." Put another way, for many of us anxiety is a well worn brain pathway that is automatic and reflects the way that our brain has been wired to respond to stress, fears, changes, relationships, etc. Why do I get so anxious when I meet new people? Because over a lifetime that response has just been strengthened over and over again, without strong enough alternatives to replace it.

Recognizing Stress

One of the first fundamental strategies for managing anxiety is to recognize how stress impacts your baseline for "emotional flexibility." When we are more stressed our baseline for what can set off anxiety is lowered.

If I'm trying to juggle making lunch for the kids, a toddler pulling at my leg, and an upcoming meeting, it is much more likely that the next stressor to occur (e.g., a stressful text from a friend) will set me "off". This is because when your body is stressed, and continues to be stressed over periods of time, your brain struggles to differentiate between small and big stressors. In a stressed brain, it's all the same level of threat.

So, the first step is to recognize what your body feels like at low, medium, and high levels of stress/tension. Even just being able to label your body-states can help prime your brain to be aware of anxiety responses and to be more flexible in how it responds.

Practical Management Techniques

So what works for anxiety? Let's take a look at two broad ideas and try to put some common strategies under these umbrellas:

• Disrupting Automatic/habitual Responses: Recall the idea that where attention goes, neurons flow. As anxiety responses continue to happen, neural pathways become strengthened to the point of being habit. In order to help our brains be more flexible, we need to work by introducing small disruptions to habitual reactions.

  Let's say I send a friend a text asking them to lunch, then I quickly realize they are vegan and I might have offended them with the restaurant suggestion. I furiously start to draft an apology and my mind is racing. In this scenario, disrupting this can look like putting the phone down in the middle of drafting the text, it can be deep-breathing right before I push send, or it can be naming three things that are green around me.

  What "coping-strategy" is inserted here doesn't matter, it truly is a trial-and-error process, but what does matter is disrupting the neural pathway. To start, we don't measure success by whether we stop the anxiety or whether we stop the behavior. It's just about inserting a pause. Then over time we insert longer pauses, more strategies, and eventually your brain becomes more responsive. That means, it can actually choose between a response (e.g., "My friend would tell me if I was offensive") or a reflex (e.g., "Nah, I totally offended her...").

• Lowering Baseline Stress: This one is a slower process, but it's important to setting up your brain for long-term success. Essentially, in order for your brain to respond as effectively as possible, you need to give it the conditions to be able to be well-rested and cared for.

  This is where strategies such as exercise, eating well, sleep, self-care etc. all come in. It doesn't mean that anxiety never happens or that sometimes it doesn't get carried away, but it does mean that figuring out what routines work for you long-term is more about just helping your brain be the best version of itself it can be. This can be as simple as just setting aside five minutes before and after presentations to just lay down and close your eyes. It's not a lot, but your brain will understand and thank you for it.

Seeking Professional Guidance

There's no doubt that anxiety (as just a physical response) is a normal part of life. But, we can work to not let it fill up all of the space and we can work on creating smaller containers.

If anxiety continues to interfere with daily life, it may be beneficial to seek help from a mental health professional. Therapies such as cognitive-behavioral therapy (CBT) or psychodynamic therapy have all been shown to be effective. Part of what therapy does is it works to help you become aware of these automatic responses and brainstorm ways to introduce alternative approaches.

Whether it's changing/being mindful of thoughts, reaching out to friends, being more vulnerable with emotions, etc. All of these things in therapy help your brain find new ways of responding to stress, which basically means creating new neural pathways.

In conclusion, while anxiety can be challenging, understanding it and implementing effective management strategies can significantly improve quality of life. Remember, it's about trying to disrupt well-developed neural pathways (what it is doesn't matter, it's the pause that matters). There isn't an easy or quick fix, it's about a gradual process of helping your brain develop more responsiveness and alternative habits. Therapy helps, but it absolutely has to be grounded in research around how brains work and how we create new habits. To learn more about neural pathways, check out Dr. Daniel Siegel's work on YouTube!